Bova_Score v.1
Bova Score is used to predict the intermediate and high-risk levels of developing pulmonary embolism (PE) related complications and mortality in hemodynamically stable (Systolic BP >=90mmhg) patients. It considers four attributes, namely, heart rate, systolic BP, elevated cardiac troponin levels and Right Ventricular (RV) dysfunction
Records the scores of each attribute, heart rate, systolic BP, elevated cardiac troponin levels and Right Ventricular (RV) dysfunction. The scores are added up to obtain the Bova Score and are accordingly stratified to different risk levels of developing complications and mortality with confirmed cases of pulmonary embolism in hemodynamically stable patient.
This is used in hemodynamically stable patients diagnosed with pulmonary embolism. The attributes used to obtain the Bova score are; Heart rate (beats/min) - <110 beats/min - 0 points, >=110 beats /min – 1point Systolic BP (mmHg) - >100 mmHg - 0 points, 90 – 100 mmHg – 2 points Elevated cardiac troponin levels – is based on standard manufacturer assays and cutoff values – No – 0 points, Yes – 2 points RV dysfunction – The diagnosis of RV dysfunction is made when on TTE (Transthoracic Echocardogram): Right to left ventricular (RV/LV) ratio >0.9, systolic pulmonary artery pressure (sPAP) >30, RV end diastolic diameter >30mm, RV dilation, or free wall hypokinesis. On CT: RV/LV ratio >1 based on short axis diameter measurements – No – 0 points. Yes – 2 points. The total score, Bova score ranges from 0 to 7. Based on this score risk levels for Pulmonary related complications and mortality at 30 days are predicted. Pulmonary embolism (PE) related complications are defined as a composite including death from PE, hemodynamic collapse, or recurrent nonfatal PE. Hemodynamic collapse = systolic BP <90 mm Hg for at least 15 min or need for catecholamines, thrombolysis, endotracheal intubation, or CPR. Bova Score Stage PE related complications PE related mortality 0-2 I (Low risk) 4.4% 3.1% 3-4 II ( Intermediate risk) 18% 6.8% >4 III (High risk) 42% 10%
Bova score should not be used in hemodynamically unstable patient (sBP < 90mmHg)
1. Bova C, Sanchez O, Prandoni P, Lankeit M, Konstantinides S, Vanni S, et al. Identification of intermediate-risk patients with acute symptomatic pulmonary embolism. European Respiratory Journal. 2014 Sep 1;44(3):694–703. 2. Fernández C, Bova C, Sanchez O, Prandoni P, Lankeit M, Konstantinides S, et al. Validation of a Model for Identification of Patients at Intermediate to High Risk for Complications Associated With Acute Symptomatic Pulmonary Embolism. CHEST. 2015 Jul 1;148(1):211–8. 3. Bova C, Vanni S, Prandoni P, Morello F, Dentali F, Bernardi E, et al. A prospective validation of the Bova score in normotensive patients with acute pulmonary embolism. Thrombosis Research. 2018 May 1;165:107–11.
OBSERVATION.bova_score_for_pulmonary_embolism_complications.v0, EVALUATION.bova_score_assessment.v0
